Topical Collection "Hybrid Imaging in Medicine"

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A topical collection in Diagnostics (ISSN 2075-4418).

Editors

Collection Editor
Prof. Dr. Andreas Kjaer

Department of Clinical Physiology, Nuclear Medicine & PET National University Hospital, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
Phone: +45 3545 4216
Fax: +45 3545 4015
Interests: molecular imaging; medical imaging; cancer; cardiovascular disease; PET; SPECT
Guest Editor
Prof. Dr. Gary Cook (Website)

Cancer (Imaging) Department, King's College London, Lambeth Wing, St Thomas', SE1 7EH, United Kingdom

Topical Collection Information

Dear Colleagues,

Medical imaging techniques are of paramount value in clinical medicine and as research tools. The techniques are rapidly improving and new techniques are continuously implemented.
Whereas every technique has advantages and shortcomings, imaging techniques are often complementary, and therefore, a current trend is the integration of different imaging techniques for hybrid imaging.
Examples of such synergistic hybrid imaging is PET/CT, which is now more common than PET-only scans. Recently, hybrid PET/MRI scanners have also been introduced in clinical use. Moreover, developments for combining ultrasonography with other modalities are on their way. Integration of morphological and functional imaging seems to be especially useful. However, combinations of several functional modalities may add value and allow for better tissue characterization.

This collection invites submission of both original and review papers within all aspects of hybrid imaging.

Prof. Dr. Andreas Kjaer
Prof. Dr. Gary Cook
Collection Editors

Manuscript Submission Information

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Keywords

  • positron emission tomography
  • computed tomography (CT)
  • magnetic resonsnace imaging (MRI)
  • magnetic resonance spectroscopy (MRS)
  • ultrasonography
  • optical imaging
  • fluorescence
  • bioluminiscence
  • PET/CT
  • PET/MRI

Published Papers (13 papers)

2016

Jump to: 2015, 2014

Open AccessReview Dynamic Contrast-Enhanced CT in Patients with Pancreatic Cancer
Diagnostics 2016, 6(3), 34; doi:10.3390/diagnostics6030034
Received: 8 August 2016 / Revised: 22 August 2016 / Accepted: 24 August 2016 / Published: 6 September 2016
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Abstract
The aim of this systematic review is to provide an overview of the use of Dynamic Contrast-enhanced Computed Tomography (DCE-CT) in patients with pancreatic cancer. This study was composed according to the PRISMA guidelines 2009. The literature search was conducted in PubMed, [...] Read more.
The aim of this systematic review is to provide an overview of the use of Dynamic Contrast-enhanced Computed Tomography (DCE-CT) in patients with pancreatic cancer. This study was composed according to the PRISMA guidelines 2009. The literature search was conducted in PubMed, Cochrane Library, EMBASE, and Web of Science databases to identify all relevant publications. The QUADAS-2 tool was implemented to assess the risk of bias and applicability concerns of each included study. The initial literature search yielded 483 publications. Thirteen articles were included. Articles were categorized into three groups: nine articles concerning primary diagnosis or staging, one article about tumor response to treatment, and three articles regarding scan techniques. In exocrine pancreatic tumors, measurements of blood flow in eight studies and blood volume in seven studies were significantly lower in tumor tissue, compared with measurements in pancreatic tissue outside of tumor, or normal pancreatic tissue in control groups of healthy volunteers. The studies were heterogeneous in the number of patients enrolled and scan protocols. Perfusion parameters measured and analyzed by DCE-CT might be useful in the investigation of characteristic vascular patterns of exocrine pancreatic tumors. Further clinical studies are desired for investigating the potential of DCE-CT in pancreatic tumors. Full article
Figures

Figure 1

Open AccessCommunication 18F-FET-PET in Primary Hyperparathyroidism: A Pilot Study
Diagnostics 2016, 6(3), 30; doi:10.3390/diagnostics6030030
Received: 27 June 2016 / Revised: 9 August 2016 / Accepted: 11 August 2016 / Published: 17 August 2016
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Abstract
Preoperative localisation of the diseased parathyroid gland(s) in primary hyperparathyroidism (PHP) is a prerequisite for subsequent minimally invasive surgery. Recently, as alternatives to conventional sestamibi parathyroid scintigraphy, the 11C-based positron emission tomography (PET) tracers methionine and choline have shown promise for [...] Read more.
Preoperative localisation of the diseased parathyroid gland(s) in primary hyperparathyroidism (PHP) is a prerequisite for subsequent minimally invasive surgery. Recently, as alternatives to conventional sestamibi parathyroid scintigraphy, the 11C-based positron emission tomography (PET) tracers methionine and choline have shown promise for this purpose. We evaluated the feasibility of using the 18F-based PET tracer fluoroethyl-l-tyrosine (FET), as the longer half-life of 18F makes it logistically more favourable. As a proof-of-concept study, we included two patients with PHP in which dual-isotope parathyroid subtraction single photon emission computed tomography had determined the exact location of the parathyroid adenoma. A dynamic FET PET/CT scan was performed with subsequent visual evaluation and calculation of target-to-background (TBR; parathyroid vs. thyroid). The maximum TBR in the two patients under study was achieved approximately 30 min after the injection of the tracer and was 1.5 and 1.7, respectively. This ratio was too small to allow for confident visualisation of the adenomas. FET PET/CT seems not feasible as a preoperative imaging modality in PHP. Full article
Figures

Figure 1

Open AccessInteresting Images Potential Pitfalls on the 99mTc-Mebrofenin Hepatobiliary Scintigraphy in a Patient with Biliary Atresia Splenic Malformation Syndrome
Diagnostics 2016, 6(1), 5; doi:10.3390/diagnostics6010005
Received: 11 December 2015 / Revised: 29 December 2015 / Accepted: 31 December 2015 / Published: 7 January 2016
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Abstract
Biliary atresia (BA) is an obliterative cholangiopathy affecting 1:10.000–14.000 of newborns. Infants with Biliary Atresia Splenic Malformation syndrome (BASM) are a subgroup of BA patients with additional congenital anomalies. Untreated the disease will result in fatal liver failure within the first years [...] Read more.
Biliary atresia (BA) is an obliterative cholangiopathy affecting 1:10.000–14.000 of newborns. Infants with Biliary Atresia Splenic Malformation syndrome (BASM) are a subgroup of BA patients with additional congenital anomalies. Untreated the disease will result in fatal liver failure within the first years of life. Kasai portoenterostomy restores bile flow and delay the progressive liver damage thereby postponing liver transplantation. An early diagnosis is of most importance to ensure the effectiveness of the operation. The 99mTc-Mebrofenin hepatobiliary scintigraphy is part of the diagnostic strategy when an infant presents jaundice due to conjugated hyperbilirubinemia (>20 µmol/L total bilirubin of which 20% is conjugated) with its high sensitivity of 97%–100% in refuting BA. Rapid extraction of tracer by the liver and no visible tracer in the small bowl after 24 h is indicative of BA. Laparotomy with antegrade cholangiography is then performed giving the final diagnosis when the remains of the obliterated biliary tree are revealed in the case of BA. We present a case demonstrating some of the challenges of interpreting the 99mTc-Mebrofenin hepatobiliary scintigraphy in an infant with BASM and stress the importance that the 99mTc-Mebrofenin hepatobiliary scintigraphy is part of a spectrum of imaging modalities in diagnosing BA. Full article
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2015

Jump to: 2016, 2014

Open AccessInteresting Images Angiosarcoma of the Scalp: Metastatic Pulmonary Cystic Lesions Initially Misinterpreted as Benign Findings on 18F-FDG PET/CT
Diagnostics 2016, 6(1), 1; doi:10.3390/diagnostics6010001
Received: 5 December 2015 / Revised: 14 December 2015 / Accepted: 15 December 2015 / Published: 22 December 2015
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Abstract
Angiosarcomas are rare and only represent about 2% of all soft tissue sarcomas. They arise from vascular or lymphatic endothelial cells and are most commonly located in the heart, liver, breast, and skin. Cutaneous angiosarcoma of the scalp is highly malignant and [...] Read more.
Angiosarcomas are rare and only represent about 2% of all soft tissue sarcomas. They arise from vascular or lymphatic endothelial cells and are most commonly located in the heart, liver, breast, and skin. Cutaneous angiosarcoma of the scalp is highly malignant and with dismal prognosis. Reported five-year survival is <30%. The mainstay of treatment is surgical resection and adjuvant radiation therapy, but failure rates following local therapy are high. Cutaneous angiosarcoma of the scalp has a predilection for pulmonary metastases with a variety of morphologic patterns on imaging. Metastatic disease in terms of pulmonary thin-walled, cystic lesions, may not be hypermetabolic on 18F-FDG PET and, as such, could be misinterpreted as benign findings. We present a case demonstrating the diagnostic uncertainty and delay in an elderly male with angiosarcoma of the scalp presenting with metastatic lung lesions following failure of local therapy. Full article
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Open AccessReview Role of Hybrid Brain Imaging in Neuropsychiatric Disorders
Diagnostics 2015, 5(4), 577-614; doi:10.3390/diagnostics5040577
Received: 5 October 2015 / Revised: 21 November 2015 / Accepted: 26 November 2015 / Published: 4 December 2015
Cited by 2 | PDF Full-text (1753 KB) | HTML Full-text | XML Full-text
Abstract
This is a focused review of imaging literature to scope the utility of hybrid brain imaging in neuropsychiatric disorders. The review focuses on brain imaging modalities that utilize hybrid (fusion) techniques to characterize abnormal brain molecular signals in combination with structural and [...] Read more.
This is a focused review of imaging literature to scope the utility of hybrid brain imaging in neuropsychiatric disorders. The review focuses on brain imaging modalities that utilize hybrid (fusion) techniques to characterize abnormal brain molecular signals in combination with structural and functional changes that have been observed in neuropsychiatric disorders. An overview of clinical hybrid brain imaging technologies for human use is followed by a selective review of the literature that conceptualizes the use of these technologies in understanding basic mechanisms of major neuropsychiatric disorders and their therapeutics. Neuronal network abnormalities are highlighted throughout this review to scope the utility of hybrid imaging as a potential biomarker for each disorder. Full article
Open AccessInteresting Images Pelvic Actinomycosis Associated with an Intrauterine Contraceptive Device Demonstrated on F-18 FDG PET/CT
Diagnostics 2015, 5(3), 369-371; doi:10.3390/diagnostics5030369
Received: 29 July 2015 / Revised: 19 August 2015 / Accepted: 20 August 2015 / Published: 28 August 2015
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Abstract
A 44-year-old woman with a history of dysmenorrhea, obstipation, and low back pain was investigated for gynecological disorder. Physical examination indicated a “frozen pelvis”. Ultrasound examination revealed the ovaries adherent to the uterus, bilateral ovarian cysts, and an intrauterine contraceptive device in [...] Read more.
A 44-year-old woman with a history of dysmenorrhea, obstipation, and low back pain was investigated for gynecological disorder. Physical examination indicated a “frozen pelvis”. Ultrasound examination revealed the ovaries adherent to the uterus, bilateral ovarian cysts, and an intrauterine contraceptive device in situ, which reportedly had been in place for 19 years. Prior to a scheduled laparoscopy, the patient returned with oedema of the lower abdomen and legs, fatigue, and weight loss. Laboratory findings included elevated CA-125, anemia, leucocytosis and high C-reactive protein. Pelvic actinomycosis was subsequently diagnosed. We report the PET/CT appearance of this condition. Full article
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Open AccessReview PET/MRI in Oncological Imaging: State of the Art
Diagnostics 2015, 5(3), 333-357; doi:10.3390/diagnostics5030333
Received: 16 June 2015 / Revised: 9 July 2015 / Accepted: 10 July 2015 / Published: 21 July 2015
Cited by 1 | PDF Full-text (4938 KB) | HTML Full-text | XML Full-text
Abstract
Positron emission tomography (PET) combined with magnetic resonance imaging (MRI) is a hybrid technology which has recently gained interest as a potential cancer imaging tool. Compared with CT, MRI is advantageous due to its lack of ionizing radiation, superior soft-tissue contrast resolution, [...] Read more.
Positron emission tomography (PET) combined with magnetic resonance imaging (MRI) is a hybrid technology which has recently gained interest as a potential cancer imaging tool. Compared with CT, MRI is advantageous due to its lack of ionizing radiation, superior soft-tissue contrast resolution, and wider range of acquisition sequences. Several studies have shown PET/MRI to be equivalent to PET/CT in most oncological applications, possibly superior in certain body parts, e.g., head and neck, pelvis, and in certain situations, e.g., cancer recurrence. This review will update the readers on recent advances in PET/MRI technology and review key literature, while highlighting the strengths and weaknesses of PET/MRI in cancer imaging. Full article
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Open AccessReview Hybrid Imaging for Patient-Specific Dosimetry in Radionuclide Therapy
Diagnostics 2015, 5(3), 296-317; doi:10.3390/diagnostics5030296
Received: 2 June 2015 / Revised: 29 June 2015 / Accepted: 1 July 2015 / Published: 10 July 2015
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Abstract
Radionuclide therapy aims to treat malignant diseases by systemic administration of radiopharmaceuticals, often using carrier molecules such as peptides and antibodies. The radionuclides used emit electrons or alpha particles as a consequence of radioactive decay, thus leading to local energy deposition. Administration [...] Read more.
Radionuclide therapy aims to treat malignant diseases by systemic administration of radiopharmaceuticals, often using carrier molecules such as peptides and antibodies. The radionuclides used emit electrons or alpha particles as a consequence of radioactive decay, thus leading to local energy deposition. Administration to individual patients can be tailored with regards to the risk of toxicity in normal organs by using absorbed dose planning. The scintillation camera, employed in planar imaging or single-photon emission computed tomography (SPECT), generates images of the spatially and temporally varying activity distribution. Recent commercially available combined SPECT and computed tomography (CT) systems have dramatically increased the possibility of performing accurate dose planning by using the CT information in several steps of the dose-planning calculation chain. This paper discusses the dosimetry chain used for individual absorbed-dose planning and highlights the areas where hybrid imaging makes significant contributions. Full article
Figures

Open AccessInteresting Images Brown Tumors Due to Primary Hyperparathyroidism in a Patient with Parathyroid Carcinoma Mimicking Skeletal Metastases on 18F-FDG PET/CT
Diagnostics 2015, 5(3), 290-293; doi:10.3390/diagnostics5030290
Received: 23 June 2015 / Revised: 6 July 2015 / Accepted: 6 July 2015 / Published: 9 July 2015
Cited by 1 | PDF Full-text (2919 KB) | HTML Full-text | XML Full-text
Abstract
Parathyroid carcinoma only represents <1% of all cases of primary hyperparathyroidism (PHPT). Even rare, chronic PHPT may lead to excessive osteoclast activity, and the increased resorption leads to destruction of cortical bone and formation of fibrous cysts with deposits of hemosiderin—so-called brown [...] Read more.
Parathyroid carcinoma only represents <1% of all cases of primary hyperparathyroidism (PHPT). Even rare, chronic PHPT may lead to excessive osteoclast activity, and the increased resorption leads to destruction of cortical bone and formation of fibrous cysts with deposits of hemosiderin—so-called brown tumors. These benign, osteolytic lesions may demonstrate FDG-avidity on 18F-FDG PET/CT, and as such are misinterpreted as skeletal metastases. Regression of the lesions may occur following successful treatment. We present a case demonstrating the diagnostic work-up and follow-up of a patient with PHPT due to parathyroid carcinoma and with presence of brown tumors on 18F-FDG PET/CT, visualizing the possible role of this imaging modality in the evaluation of treatment response in these patients. Full article
Figures

Open AccessInteresting Images In Vivo Phenotyping of Tumor Metabolism in a Canine Cancer Patient with Simultaneous 18F-FDG-PET and Hyperpolarized 13C-Pyruvate Magnetic Resonance Spectroscopic Imaging (hyperPET): Mismatch Demonstrates that FDG may not Always Reflect the Warburg Effect
Diagnostics 2015, 5(3), 287-289; doi:10.3390/diagnostics5030287
Received: 13 May 2015 / Revised: 17 June 2015 / Accepted: 19 June 2015 / Published: 26 June 2015
Cited by 1 | PDF Full-text (677 KB) | HTML Full-text | XML Full-text
Abstract
In this communication the mismatch between simultaneous 18F-FDG-PET and a 13C-lactate imaging (hyperPET) in a biopsy verified squamous cell carcinoma in the right tonsil of a canine cancer patient is shown. The results demonstrate that 18F-FDG-PET may not always [...] Read more.
In this communication the mismatch between simultaneous 18F-FDG-PET and a 13C-lactate imaging (hyperPET) in a biopsy verified squamous cell carcinoma in the right tonsil of a canine cancer patient is shown. The results demonstrate that 18F-FDG-PET may not always reflect the Warburg effect in all tumors. Full article
Figures

2014

Jump to: 2016, 2015

Open AccessArticle The Impact of Transient Hepatic Attenuation Differences in the Diagnosis of Pseudoaneurysm and Arteriovenous Fistula on Follow-Up CT Scans after Blunt Liver Trauma
Diagnostics 2014, 4(3), 129-139; doi:10.3390/diagnostics4030129
Received: 19 May 2014 / Revised: 21 July 2014 / Accepted: 8 August 2014 / Published: 10 September 2014
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Abstract
A feared complication to liver trauma is delayed vascular complication, such as pseudoaneurysm and arteriovenous fistula (PS/AF) seen as focal enhancement on contrast-enhanced computed tomography (CT) in the arterial phase. A hyperdense area termed transient hepatic attenuation difference (THAD) representing altered hepatic [...] Read more.
A feared complication to liver trauma is delayed vascular complication, such as pseudoaneurysm and arteriovenous fistula (PS/AF) seen as focal enhancement on contrast-enhanced computed tomography (CT) in the arterial phase. A hyperdense area termed transient hepatic attenuation difference (THAD) representing altered hepatic blood flow can be seen in the arterial phase near the liver lesion. The objective of this study was to describe THAD and PS/AF on follow-up CT after blunt liver trauma, and to evaluate if THAD influenced the evaluation of PS/AF. Three radiology residents retrospectively evaluated scans of 78 patients. The gold standard for PS/AF was an evaluation by an experienced senior radiologist, while THAD was a consensus between the residents. PS/AF was present in 14% and THAD in 54%. THAD was located in the periphery of the lesion with hazy borders and mean HU levels of 100, while PS/AF was located within the lesion with focal enhancement and mean HU levels of 170 (p < 0.05). In evaluation of PS/AF, the likelihood of agreement between the observers and the gold standard was 89% when THAD was present, and 98% when THAD was absent (p = 0.04). THAD is common and can hamper the evaluation of PS/AF. Full article
Open AccessReview Endoscopic Optical Coherence Tomography for Clinical Gastroenterology
Diagnostics 2014, 4(2), 57-93; doi:10.3390/diagnostics4020057
Received: 2 February 2014 / Revised: 18 April 2014 / Accepted: 22 April 2014 / Published: 5 May 2014
Cited by 6 | PDF Full-text (1004 KB) | HTML Full-text | XML Full-text
Abstract
Optical coherence tomography (OCT) is a real-time optical imaging technique that is similar in principle to ultrasonography, but employs light instead of sound waves and allows depth-resolved images with near-microscopic resolution. Endoscopic OCT allows the evaluation of broad-field and subsurface areas and [...] Read more.
Optical coherence tomography (OCT) is a real-time optical imaging technique that is similar in principle to ultrasonography, but employs light instead of sound waves and allows depth-resolved images with near-microscopic resolution. Endoscopic OCT allows the evaluation of broad-field and subsurface areas and can be used ancillary to standard endoscopy, narrow band imaging, chromoendoscopy, magnification endoscopy, and confocal endomicroscopy. This review article will provide an overview of the clinical utility of endoscopic OCT in the gastrointestinal tract and of recent achievements using state-of-the-art endoscopic 3D-OCT imaging systems. Full article
Open AccessArticle Development of a Hybrid Nanoprobe for Triple-Modality MR/SPECT/Optical Fluorescence Imaging
Diagnostics 2014, 4(1), 13-26; doi:10.3390/diagnostics4010013
Received: 29 January 2014 / Revised: 28 February 2014 / Accepted: 4 March 2014 / Published: 10 March 2014
Cited by 1 | PDF Full-text (1435 KB) | HTML Full-text | XML Full-text
Abstract
Hybrid clinical imaging is an emerging technology, which improves disease diagnosis by combining already existing technologies. With the combination of high-resolution morphological imaging, i.e., MRI/CT, and high-sensitive molecular detection offered by SPECT/PET/Optical, physicians can detect disease progression at an early stage [...] Read more.
Hybrid clinical imaging is an emerging technology, which improves disease diagnosis by combining already existing technologies. With the combination of high-resolution morphological imaging, i.e., MRI/CT, and high-sensitive molecular detection offered by SPECT/PET/Optical, physicians can detect disease progression at an early stage and design patient-specific treatments. To fully exploit the possibilities of hybrid imaging a hybrid probe compatible with each imaging technology is required. Here, we present a hybrid nanoprobe for triple modality MR/SPECT/Fluorescence imaging. Our imaging agent is comprised of superparamagnetic iron oxide nanoparticles (SPIONs), labeled with 99mTc and an Alexa fluorophore (AF), together forming 99mTc-AF-SPIONs. The agent was stable in human serum, and, after subcutaneous injection in the hind paw of Wistar rats, showed to be highly specific by accumulating in the sentinel lymph node. All three modalities clearly visualized the imaging agent. Our results show that a single imaging agent can be used for hybrid imaging. The use of a single hybrid contrast agent permits simultaneous hybrid imaging and, more conventionally, allow for single modality imaging at different time points. For example, a hybrid contrast agent enables pre-operative planning, intra-operative guidance, and post-operative evaluation with the same contrast agent. Full article

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